Abstract
Newer treatments, specifically cognitive behavioral therapy and serotonergic agents, have helped significantly in symptom amelioration.It is estimated that the symptoms of approximately 50% of patients respond partially to a trial with antidepressants. Consequently, a significant number of patients are left with residual symptoms and disability.
Some patients who do not respond to an SRI trial may respond upon addition of a low dose of an antipsychotics. Augmentation with other several agents such as lithium, buspirone, pindolol has been tried with variable success in soma patients.
A little is known about efficacy of rTMS in this diagnosis. Chronic refractory OCD causing documented persistent, severe disability is sometimes treated palliatively with neurosurgical procedures such as anterior cingulotomy or anterior capsulotomy